Speculum

ABSTRACT

A speculum  10  includes a main body  12  with two dialator fingers  14 A and  14 B that are connected at their respective proximal ends  16 A and  16 B to the main body  12.  A further dialator finger  28  extends between the fingers  14 A and  14 B and is fixed to the main body  12.  An actuator  20  is pivotally coupled to the main body  12.  The actuator  20  is formed with a dialator finger  70  that is located between the fingers  14 A and  14 B and opposite the fixed finger  28.  When the actuator  20  is pivoted the finger  70  immediately commences to pivot away from the remaining fingers  14  and  28.  After a predetermined degree of pivot, the actuator  20  comes into contact with the inside of fingers  14  near their approximal ends  16  to cause the distal ends of those fingers to move away from each other. Fingers  14 A and  14 B are hinged about respective canted hinge axis so that when they are abutted by the actuator  20  they move in a combined upward and sideways motion.

RELATED APPLICATION

This application is a continuation of U.S. patent application Ser. No.09/381,017, filed Sep. 14, 1999, for “Speculum,” U.S. Pat. No.6,174,282, which is a U.S. nationalization of International ApplicationNo. PCT/AU98/00737, filed Sep. 9, 1998.

FIELD OF THE INVENTION

This invention relates to a speculum for dilating, visualising andinstrumenting a body cavity such as a vagina or rectum.

BACKGROUND OF THE INVENTION

A conventional speculum comprises a plurality of dilator members or armswhich are spread by an actuator for enlarging a body cavity. There arecommonly two types of actuators, the lever type and the cam or iristype. The lever type actuator typically comprises a pair of handles eachhaving one dilator arm arranged in a manner so that when the handles arcsqueezed together the dilator arms spread apart. An inherent drawbackwith most lever type speculums is that the levers or handles aredisposed in the line of sight of the body cavity therefore obscuring aview of the cavity under examination and/or interfering with theplacement of medical instruments.

In the iris type speculums, the dilator arms are moved outwardly in aspiralling motion. As a result, the arms must slide against the tissuein the cavity being examined which may cause pinching of the tissue ordiscomfort to the patient. A further disadvantage with the known iristype speculums is their relatively complex construction and manufacturewhich increases costs to the extent that the speculums are in general,intended for multiple use. This therefore necessitates a strict hygieneand sterilisation program to ensure that there is no cross infectionbetween patients. Accordingly, the use of iris type speculums isgenerally inconvenient to practitioners and increases the cost ofservice.

A further generation of speculums is known in which a rotating annularcam bears against the side of pivotal dilator arms causing the arms topivot outwardly. An example of such a speculum is shown in Applicant'sInternational application no. PCT/AU96/00125 (WO 96/28083). While thistype of speculum has several advantages over the lever and iris typespeculums described above, it is still relatively complex in manufacturerequiring the production of numerous separate components which must thenbe assembled into the complete speculum.

SUMMARY OF THE INVENTION

It is an object of the present invention to provide a speculum which isinexpensive to manufacture and assemble and thus can be producedeconomically to facilitate once only disposable use and does notadversely affect visualisation or instrumenting of a body cavity.

According to the present invention there is provided a speculum body fordilating a body cavity, said speculum including at least:

a main body;

a plurality of first dilator fingers, each of said first fingers havinga proximal end and a distal end, said first dilator fingers hinged attheir proximal ends to said main body about respective canted hinge axesto allow said first dilator fingers to move with a combined upward andsideways motion; and

an actuator pivotally coupled to said main body so that said actuatorcan be pivoted into abutment with said first dilator fingers to causesaid first dilator fingers to move outwardly with said combined upwardand sideways motion thereby dilating said body cavity.

Preferably a short rib is provided on an inside surface adjacent saidproximal end of each of said first dilator fingers, said rib beingengaged by said actuator to effect said abutment of said actuator withsaid first dilator fingers.

Preferably each rib is provided with a recess for receiving saidactuator when said actuator is pivoted into abutment with said firstfingers.

Preferably said rib and said hinge axis of a corresponding first dilatorfinger are offset from each other in a direction transverse to alongitudinal axis of said corresponding finger.

Preferably said hinge axis and said rib of corresponding finger aredisposed on opposite sides of said longitudinal axis of saidcorresponding finger.

Preferably said main body includes a first ring-like structure to whichsaid first dilator fingers are hinged and said actuator comprises asecond ring-like structure which pivots inside said first ring-likestructure, said first and second ring-like structures defining a windowthrough which said cavity can be viewed when said actuator is pivotedinto abutment with said first dilator fingers.

Preferably the speculum further includes a second dilator finger locatedbetween adjacent first dilator fingers, said second dilator fingerhaving a proximal end attached to said actuator, a distal end spacedfrom said proximal end, and opposite lateral edges extending betweensaid proximal end and said distal end, said distal end of said seconddilator finger extending beyond said distal end of said first dilatorfingers.

Preferably the speculum further includes a third dilator finger coupledto said main body and located between adjacent first dilator fingersopposite said second dilator finger, said third dilator finger having adistal end that extends beyond said distal end of said first dilatorfingers and said distal end of said second dilator finger.

Preferably said third dilator finger is coupled by an integral hinge tosaid main body.

Preferably said actuator pivots through a first angle prior to abutmentwith said first dilator fingers so that said second finger commences tomove before said first dilator fingers.

Preferably the speculum further includes a releasable locking mechanismfor locking said fingers in a desired juxtaposition and subsequentlyreleasing said fingers.

Preferably said releasable locking mechanism includes a first componentprovided on said actuator and a second component provided on said mainbody, said first and second components arranged to engage each otherwhen said actuator is pushed in a direction of insertion of saidspeculum into said body cavity, and released from each other when aforce is applied to said actuator to a direction oblique to saiddirection of insertion.

Preferably said first component comprises one of a pawl and a rack ofteeth-like projections, and the second component comprises the other ofthe pawl and the rack, said pawl and rack being biased into engagementwhen said actuator is pushed in said direction of insertion, and liftedapart to effect disengagement when said force is applied.

BRIEF DESCRIPTION OF THE DRAWINGS

An embodiment of the present invention will now be described by way ofexample only, with reference to the accompanying drawings in which:

FIG. 1 is a perspective view from the front of a speculum in accordancewith a first embodiment of the present invention;

FIG. 2 is a perspective view of the speculum shown in FIG. 1 from therear;

FIG. 3 is a side view of the speculum;

FIG. 4 is a top view of the speculum;

FIG. 5 is a front end view of the speculum;

FIG. 6 is a sectional view of the speculum; and,

FIG. 7 is an enlarged sectional view of part of an actuator of thespeculum shown in FIG. 6.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT

The speculum 10 comprises a main body 12 and a plurality (in thisinstance two) first dilator fingers 14A and 14B (hereinafter referred tocollectively as “fingers 14”), which are each connected at theirrespective proximal ends 16A and 16B to the main body 12. The couplingof the fingers 14 to the main body 12 is in a manner so that the fingers14 and in particular their respective distal ends 18A and 18B can moveaway from each other when acted upon by actuator 20. The actuator 20 ispivotally coupled to the main body 12 so that when it is pushed in adirection of insertion of the speculum into the body cavity, theactuator pivots into abutment with the inside of the fingers 14 neartheir proximal ends 16 causing the distal ends 18 to move away from eachother thereby dilating the body cavity.

The body 12 comprises a handle 22 which terminates at its upper end witha ring or annulus type structure 24. The fingers 14 are coupled to thestructure 24 and extend in the axial direction of the structure 24 andgenerally perpendicularly to the handle 22. The fingers 14 are attachedto the structure 24 by tabs which form hinges 26. Located between thelower longitudinal edges of fingers 14A and 14B is a further finger 28.The finger 28 is fixed to the ring like structure 24 and extendsparallel to and beyond fingers 14. The main body 12, that is the handle22, ring like structure 24, hinges 26 and fingers 14 and 28 areintegrally formed as a single unit. As is evident from FIG. 1, eachhinge 26 has a hinge axis 26H which is canted or inclined relative toits respective fingers 14 so that when fingers 14 move they move with acombined upwards and sideways motion. That is the hinge axis 26H aboutwhich a finger 14 moves extends along a tangent to ring like structure24 but is inclined from the perpendicular to the longitudinal axis ofthat finger 14.

A rectangular cut-out 30 is formed on an upper part of the structure 24between the fingers 14A and 14B. On each side of the cut-out 30 is anintegrally formed detent 32. The detents 32 capture respective pins (notshown) formed on the actuator 20 to provide a snap-fit pivotalconnection between the actuator 20 and the main body 12. The detents canbe in the form of holes formed in lobes provided on opposite sides ofthe cut-out 30 for receiving the pins on the actuator 20.

A short rib 34 (see FIG. 2) is formed on the inside surface of eachfinger 14 adjacent its proximal end 16. The rib 34 extends in thedirection of the length of its respective finger 14 and is provided atan end adjacent the ring structure 24 with a recess 36 at its proximalend. Each rib 34 is offset from the hinge 26 of its corresponding finger14. Moreover, the hinge 26 and rib 34 of each finger 14 are spaced onopposite sides of longitudinal axis 38 of each finger 14, as seen mostclearly in FIG. 6.

The actuator 20 also includes a ring like structure or shell 40 havingan arcuate forward edge 42 and a rearward edge 44 which is also arcuatebut inclined to the forward edge 42 so that the depth of the shell 40generally increases from its top to its bottom. Extending rearwardly anddownwardly from the bottom of the shell 40 is a thumb rest 46. The thumbrest 46 is in the form of a concave depression formed in a downwardlydepending flange 48 integrally provided on the actuator 20.

As best seen in FIG. 6, a releasable locking mechanism 52 is providedfor locking the relative positions of the fingers so as to maintain adesired dilation of the body cavity and then allowing subsequent releaseof the fingers. The locking mechanism 52 comprises a first component inthe form of a pawl 54 which is integrally formed with the actuator 20and a rack 56 of teeth like projections formed on the inside of the ringlike structure 24 and extending centrally along a length of the finger28. The pawl 54 is part of a spring like thumb actuated releasemechanism 50 that is integrally formed with forward edge 42 of theactuator 20 and extends rearwardly to a location adjacent the rearwardedge 44.

The pawl 54 includes a tongue 58 that extends in the forward directionand disposed above the rack 56. The tongue 58 is biased so as tonormally press on the rack 56. The forward most and rearward most endsof the tongue 58 are provided with a first barb 60 and second barb 62respectively for engaging the rack 56. The barbs 60 and 62 are spaced sothat the second barb 62 does not engage the rack 56 until the first barbhas been pushed forward beyond the rack 56. Ideally the second barb 62engages the rack 56 when the speculum is approximately half fully open.In this embodiment this corresponds roughly to the actuator 20commencing to push against the inside of fingers 14. The shape andlocation of the second barb 62 provided for a greater bias against therack 56 than the first barb 60.

The shape of the pawl 54, in combination with a nature of the materialfrom which it is made and the juxtaposition of the actuator 20 to themain body 12 ensures that at all times at least one of the barbs 60, 62are maintained in bias contact with the rack 56 when the actuator 20 ispivoted inwardly to spread the fingers of the speculum 10. The purposeof the first barb 60 is mainly to provide tactile feed back to the userrather than to firmly hold the fingers in position. It is the secondbarb 62 that enables the distal ends of the fingers to be held apartwith incrementally increasing spread as it engages successive teethalong the rack 56.

To release the fingers, the release mechanism 50 is pushed upwardly.This lifts the second barb 62 out of engagement with the rack 56. By nowalso pushing backwardly the actuator can be pivoted back in a controlledmanner to close the speculum 10. The first barb 60 can still lightlyengage the rack 56 however its engagement force is easily overcome bythe upward and backward thumb pressure applied to the mechanism 50.

The actuator 20 is provided with an integral finger 70. The finger 70extends from the forward edge 42 and is accommodated at its proximal endin the cut-out 30. The previously mentioned pins which are received inthe detents 32 for pivotally coupling the actuator 20 to the main body12, extend laterally from opposite sides of the proximal end of finger70. The finger 70 is located between the upper longitudinal edges offingers 14A and 14B, and is diametrically opposite the finger 28. Thedistal end of finger 70 together with the distal end of finger 28 form aduck bill like structure when the actuator 20 is in the free or closedstate. In the embodiment shown, the distal end of the finger 28 extendsbeyond that of the finger 70. A locating lug 71 (see FIGS. 6 and 7)extends forward of edge 42 on opposite sides of the actuator 20 and sitsslightly above the rib 34 when the edge 42 is received in the recess 36of each rib 34.

The actuator 20 which includes the shell 40, thumb rest 46, mechanism50, pawl 54, lugs 71 and finger 70 is made as a single integralcomponent. Accordingly, the speculum 10 can be made from two separatecomponents which can be easily and quickly constructed without the aidof any tools by pushing or otherwise locating the pins formed on thesides of the finger 70 into the detents 32.

In order to use the speculum 10, it is simply gripped by the handle 22and slowly pushed into the cavity requiring dilation. With the thumb ofthe operator located in the thumb rest 46, the actuator 20 is pushed inthe direction of insertion to cause the actuator 20 to pivot about thepins located in the detents 32. This pivoting motion results in theimmediate pivoting of finger 70 so that its distal end moves away fromthe distal end of finger 28. While this occurs the barb 60 engagessuccessive teeth on the rack 56 to provide tactile feedback of themotion of the finger 70. After a predetermined degree of pivoting ofactuator 20, further pivoting results the barb 62 engaging the rack 56and the forward edge 42 seating in recess 36 and bearing against the rib34 on each of the fingers 14. As further thumb pressure is applied theactuator 20 continues to pivot which results in the fingers 14A and 14Bmoving about their respective hinges 26 so that their distal ends moveaway from each other. As the actuator 20 is pivoted, the second barb 62engages successive teeth on the rack 56. At any time, if the thumbpressure is released once the barb 62 engages one of the teeth, thefingers 14, 70 and 28 are held in a fixed relationship to each other.

In order to allow the liners to collapse and pivot back toward eachother, the mechanism 50 is pushed upwardly and backwardly resulting in alifting of the pawl 54 thereby disengaging the barb 62 from the rack 56.

It will be appreciated that when in use, the cavity being dilated can bevisualised Or instrumented through the shell 40 of the actuator 20 andring like structure 24 of the main body 12. As the speculum 10 can bemade from only two components and assembled in a matter of secondswithout the aid of any tools, it can be manufactured at such a low costthat it can be used once and then disposed of. Further, the actuator 20is only in abutment with the ends of fingers 14, therefore there is verylittle frictional engagement of the components of the speculum 10. Thisavoids the problem of the speculum “sticking open” due to highfrictional forces when in use. This may occur for example with speculumsin which an actuator pushes laterally against the inside surfaces ofdilator fingers to cause them to spread. In the present speculum, theactuator only pushes against the proximal ends of the fingers,essentially in the direction of insertion of the speculum.

Now that an embodiment of this invention has been described in detail,it will be apparent to those skilled in the relevant arts that numerousmodifications and variations may be made without departing from thebasic inventive concepts. For example, the finger 28 is shown as beingfixed to the main body 12 in a manner so that it does not pivot.However, it will be possible to construct the speculum 10 with thefinger 28 supported by an integral hinge similar to hinges 26 so that itcan be pivoted away from fingers 14 and 70. This will naturally requirechanges in the design of the actuator 20 so that it also abuts thedistal end of the finger 28 to cause the pivoting motion. Further, thereleasable locking mechanism 52 is not a critical part of the inventionand can be dispensed with so that the fingers can be held apart by themaintaining of thumb pressure on the thumb rest 46.

The speculum 10 can also be provided with one or more stops to limit thepivoting motion of the actuator 20 and thus the degree of spread of thefingers 14, 28 and 70. In its simplest form this could be achieved bysimply forming a stop bar or face on say the actuator 20 to come intocontact with the main body 12 after a predetermined degree of pivotingwith the actuator 20.

While the speculum 10 can be made from any material including stainlesssteel, it is preferred that it be made from a plastics material tofacilitate low manufacturing cost and ease of construction.

All such modifications and variations are deemed to be within the scopeof the present invention, the nature of which is to be determined fromthe foregoing description and the appended claims.

The claims defining the invention are as follows:
 1. A speculum body fordilating a body cavity, said speculum including at least: a main body; aplurality of first dilator fingers, each of said first fingers having aproximal end and a distal end, said first dilator fingers hinged attheir proximal ends to said main body about respective canted hinge axesto allow said first dilator fingers to move with a combined upward andsideways motion; and an actuator pivotally coupled to said main body sothat said actuator can be pivoted into abutment with said first dilatorfingers to cause said first dilator fingers to move outwardly with saidcombined upward and sideways motion thereby dilating said body cavity.2. The speculum according to claim 1 wherein a short rib is provided onan inside surface adjacent said proximal end of each of said firstdilator fingers, said rib being engaged by said actuator to effect saidabutment of said actuator with said first dilator fingers.
 3. Thespeculum according to claim 2 wherein each rib is provided with a recessfor receiving said actuator when said actuator is pivoted into abutmentwith said first fingers.
 4. The speculum according to claim 2 whereinsaid rib and said hinge axis of a corresponding first dilator finger areoffset from each other in a direction transverse to a longitudinal axisof said corresponding finger.
 5. The speculum according to claim 4wherein said hinge axis and said rib of corresponding finger aredisposed on opposite sides of said longitudinal axis of saidcorresponding finger.
 6. The speculum according to claim 1 wherein saidmain body includes a first ring-like structure to which said firstdilator fingers are hinged and said actuator comprises a secondring-like structure which pivots inside said first ring-like structure,said first and second ring-like structures defining a window throughwhich said cavity can be viewed when said actuator is pivoted intoabutment with said first dilator fingers.
 7. The speculum according toclaim 6 further including a second dilator finger located betweenadjacent first dilator fingers, said second dilator finger having aproximal end attached to said actuator, a distal end spaced from saidproximal end, and opposite lateral edges extending between said proximalend and said distal end, said distal end of said second dilator fingerextending beyond said distal end of said first dilator fingers.
 8. Thespeculum according to claim 7 further including a third dilator fingercoupled to said main body and located between adjacent first dilatorfingers opposite said second dilator finger, said third dilator fingerhaving a distal end that extends beyond said distal end of said firstdilator fingers and said distal end of said second dilator finger. 9.The speculum according to claim 8 wherein said third dilator finger iscoupled by an integral hinge to said main body.
 10. The speculumaccording to claim 9 wherein said actuator pivots through a first angleprior to abutment with said first dilator fingers so that said secondfinger commences to move before said first dilator fingers.
 11. Thespeculum according to claim 10 further including a releasable lockingmechanism for locking said fingers in a desired juxtaposition andsubsequently releasing said fingers.
 12. The speculum according to claim11 wherein said releasable locking mechanism includes a first componentprovided on said actuator and a second component provided on said mainbody, said first and second components arranged to engage each otherwhen said actuator is pushed in a direction of insertion of saidspeculum into said body cavity, and released from each other when aforce is applied to said actuator to a direction oblique to saiddirection of insertion.
 13. The speculum according to claim 12 whereinsaid first component comprises one of a pawl and a rack of teeth-likeprojections, and the second component comprises the other of the pawland the rack, said pawl and rack being biased into engagement when saidactuator is pushed in said direction of insertion, and lifted apart toeffect disengagement when said force is applied.